Current antifilarial drugs - mechanisms of action

Filarial parasites of humans and animals represent a heterogeneous group of pathogenic nematodes, interacting throughout their life cycles with two hosts and, for most species, a bacterial endosymbiont. Various control strategies have been implemented since the mid-twentieth century, including vector control in endemic zones, mass drug administration campaigns, and preventive chemotherapy in companion animals. The challenges posed by the incompletely understood biology of these long-lived pathogens, their restricted accessibility, discrepant life stage-dependent sensitivities to drugs, as well as the potential for severe adverse events, have greatly complicated progress toward elimination of human filariases. This chapter chronicles the history of antifilarial medicines and reviews current understanding of their mechanisms of action, highlighting persisting knowledge gaps some 70 years after the first efforts were undertaken to control filarial infections. © 2023 WILEY-VCH GmbH.